当院における子宮全摘術の手術成績と腹腔鏡下手術増加の背景

抄録

Objective: We retrospectively investigated the evolution of surgical procedures and surgical outcomes following total hysterectomy (TH), and discussed the background of an increase in the number of THs performed, especially in laparoscopic surgery.

Materials and Methods: The surgical procedures for TH performed at Fukushima Red Cross Hospital from 2002 to 2023 and the surgical outcomes and occurrence of complications of total laparoscopic hysterectomies (TLH) performed since 2013 were reviewed.

Results: Laparoscopic surgeries have accounted for more than half of all surgeries since 2012, and the number of laparoscopic surgeries performed has been increasing year on year since 2013. A detailed examination of the surgical outcomes of 609 TLHs performed since 2013 showed significant decreases in blood loss during surgery and the occurrence of complications. In addition, there was a significant increase in the proportion of smaller uteri (200g or less).

Conclusion: It is thought that the main reason for the increase in TH is due to a shift from laparoscopically assisted vaginal hysterectomy (LAVH) to TLH. With the spread of GnRH antagonists and dienogest, it was previously thought that medical treatment would become the mainstay of treatment for benign uterine tumors, but with the rapid spread of TLH and the growing awareness of its minimally invasive nature and safety, it appears that the number of patients who prefer or choose surgical therapy is also increasing.